Health services and rehabilitation for active duty service members and veterans with mild TBI

Pogoda, Terri K.; Levy, Charles E.; Helmick, Katherine; Pugh, Mary Jo

doi:10.1080/02699052.2016.1274777

Cited by 18 publications

(11 citation statements)

References 72 publications

(121 reference statements)

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“…A second agenda is to identify interventions that support improved integration and to evaluate the effectiveness (and cost) of such interventions. This approach is also characterised by the description and analysis of programmes, models, interventions or forms of joint work designed to improve the situation of the target group (Pogoda, Levy, Helmick, & Pugh, 2017). Given the complex character of long‐term health problems (e.g., mental health issues), these interventions themselves constitute networked services (Holwerda, Fokkens, Engbers, & Brouwer, 2016; Ståhl, Andersén, Anderzén, & Larsson, 2017).…”

Section: Four Research Approachesmentioning

confidence: 99%

Research approaches to networked employment services: A systematic review

Andreassen¹,

Breit

Saltkjel³

2020

Soc Policy Adm

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Research on networked services aimed at the (re)employment of groups marginalised from the labour market has gained momentum in different scholarly traditions (e.g., public administration, healthcare and social policy), but the topic remains somewhat fragmented. In this paper, we systematise and synthesise this research with the aim of outlining distinct research approaches, facilitating increased cross-disciplinary understandings and promoting interdisciplinary research. Based on a systematic review of the literature (1990-2018, n = 273), we highlight four dominant research approaches: rehabilitation, disability, welfare and governance. We show that these research approaches involve distinct conceptualisations of labour market inclusion, networked services and the target groups. Nevertheless, the research approaches also apply similar terms and concepts (e.g., partnership, collaboration) but with different (more or less implicit) connotations, which lead to fragmentation. We do not suggest that there be a unified use of concepts across traditions; however, we argue for the necessity of increased awareness of the similarities and differences between these research traditions in order to increase understanding of the networked employment services available to marginalised groups.

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Section: Four Research Approachesmentioning

confidence: 99%

Research approaches to networked employment services: A systematic review

Andreassen¹,

Breit

Saltkjel³

2020

Soc Policy Adm

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“…Although most concussions resolve within the first few weeks to months following injury, a subset of these patients require more extensive clinical management and experience significantly reduced productivity. 7 With proper training, primary care providers can play a crucial role in preparing patients with concussion for a successful recovery. However, many clinicians have difficulty remaining up to date about concussion recovery and empirically supported approaches to treatment.…”

Section: Introductionmentioning

confidence: 99%

Best Practices for Progressive Return to Activity after Concussion: Lessons Learned from a Prospective Study of U.S. Military Service Members

Ettenhofer

Remigio-Baker

Bailie

et al. 2020

Neurotrauma Reports

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Primary care providers can play a crucial role in the clinical management of concussion. However, many providers lack up-to-date information about best practices for rest and return to activity after these injuries. Most research on this topic has been conducted in athletes, and so less is known about how to assist patients with returning to activity in other settings and populations. This article provides a review of best practices for management of progressive return to activity after concussion, with an emphasis on ''lessons learned'' from the Defense and Veterans Brain Injury Center (DVBIC) Progressive Return to Activity (PRA) study, a multi-site longitudinal research project conducted to evaluate concussion management practices and the effectiveness of provider training on DVBIC clinical recommendations (CRs). Provider clinical practices and patient outcomes were examined at three U.S. military treatment facilities before and after providers completed a standardized training on DVBIC PRA CRs. In summary, research findings provide additional support that concussion recovery can be influenced by patients' activity levels after injury. Patients with concussion may experience poorer outcomes if they return to pre-injury levels of activity too rapidly, but they may also be at risk for prolonged symptoms if they fail to increase activity levels over time after an initial period of rest. Additionally, training primary care providers in return to activity guidelines can result in more effective patient education and better clinical outcomes. This knowledge can be used to inform best practices for progressive return to activity in both civilian and military settings.

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“…Service delivery to patients with severe TBI has focused on the acute phase, underpinning the importance of early initiated and well-organized delivery (9–11). Less is known about effective rehabilitation service delivery in the postacute and later phases, at least for the general TBI population (12, 13) and reviews focusing on this issue are warranted (14). Furthermore, the structure and process of care are seldom described, although they clearly impact the outcomes of TBI (15).…”

Section: Introductionmentioning

confidence: 99%

Randomized Controlled Trials of Rehabilitation Services in the Post-acute Phase of Moderate and Severe Traumatic Brain Injury – A Systematic Review

et al. 2019

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Background and aims: There is a gap in knowledge regarding effective rehabilitation service delivery in the post-acute phase after traumatic brain injury (TBI). Recently, Gutenbrunner et al. proposed a classification system for health-related rehabilitation services (International Classification System for Service Organization in Health-related Rehabilitation, ICSO-R) that could be useful for contrasting and comparing rehabilitation services. The ICSO-R describes the dimensions of Provision (i.e., context of delivered services), Funding (i.e., sources of income and refunding), and Delivery (i.e., mode, structure and intensity) at the meso-level of services. We aim to: -Provide an overview of randomized, controlled trials (RCTs) with rehabilitation service relevance provided to patients with moderate and severe TBI in the post-acute phase using the ICSO-R as a framework; and -Evaluate the extent to which the provision, funding and delivery dimensions of rehabilitation services were addressed and differed between the intervention arms in these studies. Materials and methods: A systematic literature search was performed in OVID MEDLINE, EMBASE, CINHAL, PsychINFO, and CENTRAL, including multidisciplinary rehabilitation interventions with RCT designs and service relevance targeting moderate and severe TBI in the post-acute phase. Results: 23 studies with 4,644 TBI patients were included. More than two-thirds of the studies were conducted in a hospital-based rehabilitation setting. The contrast in Context between the intervention arms often co-varied with Resources. The funding of the services was explicitly described in only one study. Aspects of the Delivery dimension were described in all of the studies, and the Mode of Production, Intensity, Aspects of Time and Peer Support were contrasted in the intervention arms in several of the studies. A wide variety of outcome measures were applied often covering Body function, as well as the Activities and Participation domains of the International Classification of Functioning, Disability, and Health (ICF). Conclusion: Aspects of service organization and resources as well as delivery may clearly influence outcome of rehabilitation. Presently, lack of uniformity of data and collection methods, the heterogeneity of structures and processes of rehabilitation services, and a lack of common outcome measurements make comparisons between the studies difficult. Standardized descriptions of services by ICSO-R, offer the possibility to improve comparability in the future and thus enhance the relevance of rehabilitation studies.

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Health services and rehabilitation for active duty service members and veterans with mild TBI

Abstract: There have been significant advances in TBI rehabilitation, but multiple areas across the DoD and VA care continuum need further exploration and development to meet the needs of ADSMs and Veterans.

Cited by 18 publications

References 72 publications

Research approaches to networked employment services: A systematic review

Research approaches to networked employment services: A systematic review

Best Practices for Progressive Return to Activity after Concussion: Lessons Learned from a Prospective Study of U.S. Military Service Members

Randomized Controlled Trials of Rehabilitation Services in the Post-acute Phase of Moderate and Severe Traumatic Brain Injury – A Systematic Review

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